No hepatologist in the United States, even at major medical centers, sees a sufficient number of patients to carry out controlled trials of controversial or new methods of treating acute hepatic insufficiency. Investigators of the Acute Hepatic Failure Study Group have combined their efforts for cooperative evaluations of methods of therapy. The Group is now assessing the role of corticosteroids in acute hepatic failure at 20 centers to determine whether this adjunct has any influence upon survival. Various forms of glucocorticoid have been used on a world-wide basis since 1952, but no adequately controlled study has ever been done. Small-scale studies have suggested lack of benefit or actual harm, but steroids continue to be used by practitioners. Participating investigators will randomize cases over a three-year period to determine whether corticosteroids have any influence on outcome, either early (based on survival) or long-term (based on occurrence of chronic liver disease). The study serves four additional purposes: 1) To collect data on non-randomized patients to define better the natural history of the disease. 2) To collect sera for a bank available to qualified investigators in evaluating new tests relating to prognostic factors and/or pathophysiologic concepts. 3) To maintain the structure of the AHFSG as an organization prepared to evaluate rapidly promising new therapies. 4) To facilitate informal exchanges of ideas and opinions regarding treatment of acute hepatic failure. BIBLIOGRAPHIC REFERENCES: Brachott, D.; Lifschitz, I.; Mosley, J.W.; Kendrick, M.A.; and Sgouris, J.T. Potency of Fragmented IgG: Two Studies of Post-exposure Prophylaxis in Type A Hepatitis. J. Lab. Clin. Med. 85:281-286, 1975. Karvountzis, G.G.: Mosley, J.W.: and Redeker, A.G. Serologic Characterization of Patients with Two Episodes of Acute Viral Hepatitis. Amer. J. Med. 58:815-822, 1975.